When Benefits Begin

Filing Disability Claims

If you become disabled due to a non-occupational sickness or injury, you should submit a claim to the Fund’s Administrative Office as soon as possible. In order to begin receiving your weekly benefits, the following must happen:

Your claim must be accompanied by any information or proof requested and reasonably required to process such a claim.

More about filing a claim

The Fund’s Administrative Office will make a decision on the claim and notify you of the decision within 45 days. If the Fund requires an extension of time due to matters beyond its control, you will be notified of the reason for the delay and when the decision will be made. This notification will occur before the expiration of the 45-day period. A decision will be made within 30 days of the time the Fund’s Administrative Office notifies you of the delay.

If the Fund’s Administrative Office needs additional information from you to make its decision, you will be notified as to what information must be submitted. You will have at least 45 days to submit the additional information. Once the Fund’s Administrative Office receives the information from you, you will be notified of the decision on the claim within 30 days.

The Fund’s Administrative Office will provide you with a Notice of the Adverse Benefit Determination in writing that contains the following:

The specific reasons for the adverse benefit determination;

The specific reference to the Plan and/or Summary Plan Description provisions on which the adverse benefit determination was based;

A description of any additional materials or information necessary for you to perfect your claim and an explanation of why such material or information is necessary;

The notice of any internal guidelines or protocols used in making the decision, if applicable, and your right to receive a copy;

A notice of your right to a written explanation of any exclusion which affects your claim; and